CLINICAL PREDICTORS OF MENTAL-DISORDERS AMONG MEDICAL OUTPATIENTS - VALIDATION OF THE S4 MODEL

The authors previously reported four clinical cues that predicted a su bgroup of ambulatory patients likely to have,depressive and anxiety di sorders. The authors' purpose in this study was to validate this model in another cohort of 185 consecutive adult referrals to a rheumatolog y clinic. The authors found 4 variables important in predicting mental disorders: recent stress (odds ratio [OR]: 3.3, 95% confidence interv al [CI]: 1.5-7.2); >5 somatic symptoms (OR: 4.5, 95% CI: 1.1-9.5); onl y fair or poor health status (OR: 3.4, 95% CI: 1.6-7.4); and symptom s everity (OR: 1.6, 95% CI: 0.8-3.6). There was a stepwise increase in t he likelihood of a mental disorder with an increasing number of predic tors. The authors conclude that these clinical cues may allow clinicia ns to select patients in which formal screening for mental disorders w ould be particularly fruitful.